IN 2008, AFTER 30 YEARS of practicing as an RN, I was faced with the greatest challenge of my career-caring for my terminally ill son.

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In the summer of 2007 at age 26, Matt began to complain of left-sided flank pain. He had no appetite and was losing weight. After 6 months of visiting several doctors, he still had no diagnosis. A computed tomography (CT) scan was ordered in early December and reported as negative.

By New Year's Eve, Matt's pain was intractable. I took him to the ED where another CT was performed. This time, it detected a mass. A colonoscopy revealed an almost obstructive colon tumor and the biopsy revealed malignancy. Matt had colon cancer.

At this point, everything was about Matt's pain control and preparing for surgery to remove the tumor and explore the extent of the disease. I helped him with his preps and explained all I could about what he might expect after the procedure. I listened to his fears and concerns. As a mom, I didn't want my son to hurt. As a nurse, I was afraid of what else might be found during the surgery.

The surgery revealed that the cancer had metastasized. The oncologist told us his prognosis was poor. I was heartbroken for Matt and our family and knew that he'd need me, both as a mother and a nurse. He also needed a colostomy-something he'd dreaded. Matt was able to go home after 6 weeks in the hospital.

I stayed with Matt 24/7. At home, we worked together to perfect how he'd take care of his colostomy. Drawing on my nursing knowledge and trial and error, he was able to master it quickly. Any time he had a problem he came straight to me. "Mom," he'd say, "I'm so glad you're a nurse and are able to help me."

I left my job so I could be with Matt in whatever way he needed me. Together we sat, every 2 weeks, for 4 to 5 hours while he received his chemotherapy. He'd be so sick after the treatments and was grateful for whatever I could do to make him more comfortable. The nurses in the oncology infusion clinic were fantastic. They showed so much compassion and were the epitome of what I felt nurses should be in such a setting.

After a year, more tumors were discovered in Matt's abdomen. It became clear the chemotherapy wasn't going to cure him. As a nurse I understood what was happening, but as a mom I never wanted to give up hope.

Mom and advocate

At times I found it difficult to separate my roles as mom and nurse. I wanted to be there to support his emotional needs but also felt I needed to advocate for him as much as I could.

When it became clear that Matt was out of options, he started accepting that he would die. I couldn't imagine having to come to terms with this at age 27. My nursing experience helped me recognize the stages of the grief process. Many times he wanted to talk to me about what the process of dying would be like, physically. As difficult as it was for me as a mom, I explained what he might go through.

Due to the incredible amount of pain he was experiencing, Matt had an intrathecal pump implanted. His frustration with his pain caused him, at times, to lash out at whoever was nearby-usually me. I tried to look past his behavior and realize that he was a young man with a terminal disease who was in great pain, not only physically but emotionally, and encouraged his caregivers to understand this as well.

Final gift

When it became clear that death would come soon, hospice was called and came into our home and our hearts. I saw what true nursing care and compassion could be. These nurses allowed me the freedom to be a mother first. I used my nursing skills to make Matt as comfortable as I could, giving him nightly back rubs and helping him with his colostomy care. I read to him and he was my little boy again.

Matt lost his battle with cancer on August 16, 2009, at age 28. He was surrounded by his loving family and hospice caregivers. When he took his last breath he said "Mom." It was his gift to me. He was finally free from pain.

Lessons learned

I returned to nursing in 2010. The lessons I learned have been invaluable in my daily practice. I learned how to help my son accept his fate. He faced his death with more dignity than I thought possible at his young age. I learned more than I'd ever realized about the impact that nurses have on others' lives. And for that I'm truly grateful.

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